Only in the harsh light of sobriety could Melbourne man Benn Veenker really understand the cost his addiction had on his family and friends.
"My mum and dad said for years they would spend a Friday and Saturday night praying for the phone not to ring out of fear that their son had been killed," Mr Veenker said.
"That sort of really hit home with the impact it had on them."
The 43-year-old also reflected on the financial cost of his addiction.
"I was always taking days off, waking up hung over. And so the amount of absenteeism, loss of productivity on the work site," Mr Veenker said.
Then there was the gambling as well.
"I was just constantly pouring money into machines that would never give anything back," he said.
Addictions, like Benn Veenker's, cost the Australian economy $80.3 billion in 2021, according to a new report by consulting firm KPMG and national addiction research body Turning Point.
"One in four Australians will struggle with alcohol, drugs or gambling in their lifetime," said Dan Lubman, professor of addiction studies and executive clinical director of Turning Point.
"So, I think it's no surprise that Australia has one of the highest rates of addiction-related health burdens in the world.
"But what's been unclear until now is the combined costs to the Australian community, and it's significant."
The report calls for a new national response to addiction management and harm reduction. It also spells out the need for Australians to challenge their preconceptions about addiction, and break down the stigma.
Professor Lubman said Australia should look at addiction as a health problem, rather than a moral or law enforcement issue.
"Addiction is something that we can't dismiss anymore. It's something that we need to take seriously," Professor Lubman said.
"I think one of the things that this report clearly shows is that we've got our priorities all askew."
How did the experts calculate the cost of addiction?
The report examined 60 existing studies on addiction and calculated costs associated with workplace and household productivity, harmful consumption, healthcare, justice and law enforcement, social services and to family and others.
Tobacco had the highest cost, despite Australia working hard to reduce smoking rates.
"We're still playing catch up in terms of people who've previously smoked and still are struggling with the impacts of those health harms," Professor Lubman said.
The report also calculated the cost of "loss of life" caused by addiction, using two different methods.
The first was retrospectively, by estimating "all lives lost to addiction in the past and how these losses impact on the current year". That figure was $48 billion.
The other approach looked at the future, meaning it counted all lives lost in a year and calculated their hypothetical future contributions and productivity.
This amounted to $174 billion.
"So, two very different figures based on the methodology approach, but both are highly significant in terms of really emphasising the true cost of addictions in the Australian community," Professor Lubman said.
Previous research has found Australia has the highest rate of loss to poker machines in the world.
Monash University researchers found Australians lost more than $11.4 billion to poker machines in pubs and clubs across five states in 2021.
Professor Lubman said there were limitations to the latest report, given it examined studies that were sometimes outdated and had different methodologies.
"We know it's a conservative estimate because of these gaps in the literature," Professor Lubman said.
One of the major gaps, he pointed out, was analysis on the impact of the stigma of addiction.
"There's a whole range of misconceptions and myths out there in the community," he said.
"Often people believe that addiction is not treatable and so people are in some ways discouraged from seeking help."
The report estimated that people with alcohol addiction delayed treatment for up to 18 years, partly because of this stigma.
'Shame and guilt' surrounding getting help
Mr Veenker said he felt that stigma and it delayed him getting the help he needed.
"My idea of an alcoholic was someone on a park bench drinking out of a paper bag. I felt shame and guilt about seeking help," he said.
But in rehabilitation, he found most of the people were like him.
"They were normal, everyday people trying to cope in the best way they could to trauma," he said.
"It was a massive relief."
During rehab, counsellors suggested Mr Veenker find new goals to focus on, so he chose running, which he had enjoyed as a child.
"Exercise was a big part of feeling good. I would go for a run after work and get the endorphin hit," he said.
"Constantly improving my time gave me a sense of achievement and it is still a big part of my life."
Mr Veenker retrained to be a drug and alcohol counsellor at First Step in Melbourne and now helps others struggling with addiction.
"It's great to see people change and find hope. For the first time in my life, I love what I do."
The cost of addiction report aims to make the sort of treatment Benn Vennker received more available to everyone who suffers from addiction.
"We know that about half a million Australians can't access the support they need because of lack of access to treatment, or because of judgement," Professor Lubman said.
Health economist Jason Jiang from La Trobe University said the report would help policy makers understand the "magnitude of harm" caused by addiction, as well as how money could be saved through policy change.
The costs of addiction in Australia was greater than the combined government spending on education and defence.
"That means if we provide policy on [prevention programs] effectively and provide more treatment, we can significantly reduce the social costs of addiction to Australia," Dr Jiang said.
"And this money can be used for other important things like education or in infrastructure."
